Navigating the 2025 UDS Report - Changes, Mistakes, and Best Practices

Episode Overview

Join Jill Steely and UDS expert Steve Weinman as they break down everything you need to know about the 2025 UDS report submission. From the history of this critical reporting requirement to the latest changes and common pitfalls, this episode is essential listening for any community health center leader preparing their submission.

Guest

Steve Weinman - FQHC Consultant and CEO Bootcamp Partner

• Email: [email protected]
• Has completed UDS reports every year since 1984
• Specializes in helping health centers ensure accurate, compliant submissions

Key Takeaways

1. UDS Report History & Importance

• Evolved from Bureau Common Reporting Requirements (BCRR) starting in 1984
• Became the UDS in 1996
• Used to report to Congress on how 330 grant funding is spent
• Directly impacts your patient targets and funding levels

2. Critical 2025 Changes

• Table 3B: SOGI data now optional (will be eliminated in 2026)
• Tables 6A & 7: Minor housekeeping changes to ICD-10 and CPT-4 codes
• Table 9E: COVID-related revenue lines removed
• Relatively minor year compared to the major 2026 overhaul coming

3. Major 2026 Changes (Start Preparing Now!)

• Table 4: Managed care utilization reporting ELIMINATED (huge time saver!)
• Table 5:
• Service categories renamed (enabling services → patient support services)
• QI personnel now lumped with IT personnel
• Selected service detail addendum removed
• Table 6A: Significant changes including removal of some women's health and dental metrics
• Table 8A: Complete overhaul - overhead vs. direct costs replaced with salaries/benefits vs. other costs
• Table 9D: Greatly simplified - retroactive collections eliminated, managed care categories combined
• Major shift: Moving from cash basis to accrual basis reporting

4. Most Common UDS Mistakes

High-Impact Errors:

• Undercounting or overcounting patients (affects funding targets)
• Miscategorizing staff FTEs on Table 5
• Not aligning FTEs between Table 5 and Table 8A costs
• Missing enabling services encounters
• Not capturing all charges on revenue tables

Data Collection Issues:

• Too many "unknown" entries for race/ethnicity, income
• Undercounting special populations (homeless, migrants, veterans)
• Poor quality control on data input

Financial Reporting:

• Not properly categorizing pharmacy revenue
• Misaligning costs with FTE allocation
• Not capturing non-billable service value

5. Consequences of Errors

• Funding cuts (must achieve 95% of patient target)
• Program appears less effective than it is
• Creates appearance of greater unmet need (invites competitors)
• Can trigger grant conditions
• Questionable data flags from HRSA

Best Practices for Accurate Submission

Throughout the Year

1. Run reports monthly - Don't wait until February
2. Establish a cross-functional team - Include clinical, finance, HR, and IT staff
3. Assign one coordinator with authority to engage all departments
4. Review data for reasonableness - Does it match what you're seeing clinically?
5. Quality control at data input - Garbage in, garbage out

During Submission

1. Start early - Begin review in January, not February 10th
2. Verify vendor updates - Ensure EHR and reporting tools reflect new requirements
3. Double-check FTE allocations - Match Table 5 and Table 8A
4. Capture ALL charges - Not just billable services
5. Thoughtfully answer HRSA questions - Don't copy/paste generic responses

After Submission

1. Use as strategic planning tool - Compare year-over-year trends
2. Identify operational inefficiencies
3. Document process improvements for next year
4. Create systems to prevent recurring errors

Resources Mentioned

Free UDS Submission Guide

• Download at: www.jillsteeley.com/uds
• Includes comprehensive checklist, table-by-table review timeline, common error prevention strategies, internal review template, and sample HRSA response templates

CEO Bootcamp

• Starts April 2026
• 5-month program focused on patient growth, retention, and revenue diversification
• Learn more at jillsteely.com

HRSA Resources

• Program Assistance Letter (PAL) with 2026 changes
• docs.claude.com and support.claude.com for current guidance

Key Quotes

"At the end of the day, almost invariably doing these quality things leads to more money because if you're not capturing the data properly, there's a good chance that your billing is not working properly either." - Steve Weinman

"Don't let this year's UDS submission become a crisis for everyone. Download that guide, share it with your team, and start your preparation now while you still have time to adjust and get it right." - Jill Steeley

"Preventive maintenance is always easier and cheaper than repairs. Work on it every month." - Steve Weinman

Action Items

• [ ] Download the free UDS guide at https://www.jillsteeley.com/uds
• [ ] Verify your EHR vendor has implemented 2025 changes
• [ ] Establish monthly UDS review meetings with cross-functional team
• [ ] Review the PAL for 2026 changes and begin preparation
• [ ] Check staff FTE allocations match between Table 5 and Table 8A
• [ ] Implement quality control processes for data entry
• [ ] Compare 2024 vs 2025 submissions to identify trends

Connect With Us

Jill Steely

• Website: jillsteeley.com
• Email: [email protected]

Steve Weinman

• Email: [email protected]

Next Episode

Stay tuned for more essential content for community health leaders in January and February!

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